The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

Abstract

Over 50% of the global population will experience menstruation, and menstrual disorders are extremely common and debilitating. Problematic menstruation may cause anaemia, has a significant negative impact on quality of life and is a huge socioeconomic burden for women, their families, health services and society. Standardized parameters for typical menstruation have been defined by the International Federation of Gynecology and Obstetrics (FIGO) regarding menstrual frequency, duration, regularity and volume, and deviation from these may constitute abnormal uterine bleeding. Features of the menstrual cycle are also increasingly being recognized as ‘vital signs’—acting as both indicators and possible determinants of broader health and well-being. For example: irregular and long menstrual cycles have been associated with a greater risk of premature mortality, and infrequent or absent menstruation can be an indicator of reduced fertility, which itself can be associated with a number of chronic conditions. Since the beginning of the COVID-19 pandemic, there have been accumulating discussions on social media and blogs indicating that women have experienced menstrual changes, including altered menstrual duration, frequency, regularity, and volume (heavier bleeding and clotting), increased dysmenorrhoea and worsened premenstrual syndrome (PMS) (e.g. Morgan 2021). More recent anecdotal reports of menstrual changes after vaccination for COVID-19 have fuelled vaccine hesitancy or refusal. There is an important public health imperative for accurate scientific investigation of these phenomena.

Rights

© The Author(s) 2021. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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DOI

https://doi.org/10.1093/ije/dyab239

Repository URI

https://www.research.ed.ac.uk/en/publications/44c043b2-431b-4255-94b0-8bf8230fd84e